2020 FMJ S.T.E.M. Camp- Health Form
Participants Name *
Your answer
I understand that pictures and/or videos of my child maybe taken during STEM camp while participating within STEM camp activities. These pictures may or may not be posted to any of the FMJ's or Roane County Schools websites and/or any of FMJ's or Roane County School's social media accounts. In marking YES I give permission for picture and/or videos of my child to be taken and potentially posted. In marking NO i understand that you will need to talk to Camp Director Jason Young so he can make the FMJ social media team aware of your decision.
Guardians Name *
Your answer
Guardians Email *
Your answer
Home Address *
Your answer
Emergency Phone numbers *
Your answer
Emergency Phone numbers *
Your answer
Emergency Phone numbers *
Your answer
Physicians Name *
Your answer
Physicians Phone Number *
Your answer
In case of an Emergency what Hospital would you prefer your child to go to. *
Your answer
My child may leave camp with: *
Your answer
My child may NOT leave camp with
Your answer
Medications: (Place None if there are no medications) *
Your answer
Medical conditions:(Place None if there are no medical conditions)
Your answer
Food Allergies (Place None if there are no Food Allergies)
Your answer
Other Allergies(Place None if there are no other food allergies)
Your answer
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